FDA Adverse Event Other Summary report: N

RADIESSE DERMAL FILLER

MDR report key: 2450917 · Received February 9, 2012

Report

Report Number
2135225-2012-00019
Event Type
Other
Date Received
February 9, 2012
Date of Event
December 1, 2011
Report Date
January 11, 2012
Manufacturer
MERZ AESTHETICS, INC.
Product Code
LMH
PMA / PMN Number
P050052
Adverse Event
Yes
Report Source
Manufacturer report
Reporter Location
AS
Reporter Occupation
PHYSICIAN

Narratives

Additional Manufacturer Narrative · 1

THE DEVICE HISTORY RECORDS FOR RADIESSE LOT 1022655 WERE REVIEWED. ALL REQUIRED TESTING SPECIFICATIONS FOR THE LOT WERE MET PRIOR TO RELEASE AND THERE WERE NO ABNORMALITIES NOTED. AT THE TIME OF THIS REPORT, AN UPDATE OF THE PATIENT'S SYMPTOMS HAVE NOT BEEN PROVIDED.

Description of Event or Problem · 1

ON (B)(6) 2011, A (B)(6) FEMALE PATIENT WAS INJECTED WITH 0.6 ML OF RADIESSE DERMAL FILLER IN THE NASAL BRIDGE AND TIP FOR RESHAPING. THE PATIENT SUFFERED RAPID ONSET OF CELLULITIS, REQUIRING HOSPITALIZATION AND TREATMENT WITH IV ANTIBIOTICS.

Devices

Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
1 RADIESSE DERMAL FILLER RADIESSE INJECTABLE IMPLANT LMH MERZ AESTHETICS, INC. 1022655

Patients

Seq Age Sex Outcome Treatment
1 28 YR Hospitalization